Transient elastography for diagnosis of portal hypertension in liver cirrhosis: is there still a role for hepatic venous pressure gradient measurement?

摘要

Chronic liver disease represents an important and growing cause of morbidity and mortality in the United States, affecting 360 per 100,000 persons, and ranking as the 12th leading cause of overall mortality, at the cost of greater than dollar 2 billion per year. The end stage of chronic liver disease is cirrhosis and the most frequent and lethal complications are secondary to the development of portal hypertension, including variceal hemorrhage, portosystemic encephalopathy, as-cites, spontaneous bacterial peritonitis, and the hepatore-nal syndrome. In most cases, the progression of liver disease toward cirrhosis occurs in successive stages of liver fibrosis, but the complications are always initiated by portal hypertension, which is typically determined by measuring the hepatic venous pressure gradient (HVPG).